Modifying cognitive behavioural therapy for high-functioning autism spectrum disorder

Author/s
Paul Abeles
Citation
Issue 4 Summer 2014
CEPiP.2014.1.137-142
Abstract

Cognitive Behavioural Therapy (CBT) is a psychological therapy with an evidence base in treating neurotypical adults and children with various mental health problems. CBT has been applied to individuals with high-functioning autism spectrum disorder in individual and group settings for the treatment of comorbid mental health difficulties (e.g. anxiety) and core autism-related difficulties (e.g. social understanding). This paper briefly describes the literature and considers the specific challenges of applying CBT to this population. It also describes a range of modifications to CBT that need to be made in adapting the treatment for the patient group, including taking a more directive approach, ensuring an increased use of written/visual material, a greater emphasis on affective education, avoidance of metaphor/abstract concepts, the incorporation of special interests and the involvement of family members.

Cite as: Cutting Edge Psychiatry in Practice 2014, 4(1):137-142; https://doi.org/10.65031/taxg1386

References

  1. Beck, A. T., Rush, J. A., Shaw, B. F., et al Cognitive Therapy of Depression. New York: Guilford Press; 1979.           
  2. Campbell JM. Efficacy of behavioral interventions for reducing problem behavior in persons with autism: a quantitative synthesis of single-subject research. Res Dev Disabilities 2003; 24(2):120-38. 142 https://doi.org/10.1016/s0891-4222(03)00014-3
  3. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G . Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008; 47(8):921-9 https://doi.org/10.1097/chi.0b013e318179964f
  4. Wing L. Asperger’s syndrome: A clinical account. Psychological Medicine 1981; 11, 115–130.             
  5. Sofronoff K, Attwood T, Hinton S. A randomised controlled trial of a CBT intervention for anxiety in children with Asperger syndrome. J Child Psychol Psychiatry. 2005 46(11):1152– 1160 https://doi.org/10.1111/j.1469-7610.2005.00411.x
  6. Ooi Y P, Lam C M, Sung M et al. Effects of cognitive-behavioural therapy on anxiety for children with high-functioning autistic spectrum disorders. Singapore Medical Journal 2008; 49(3), pp. 215-220.   
  7. Reaven J, Blakeley-Smith A, Culhane-Shelburne K, Hepburn S. J. Group cognitive behaviour therapy for children with high-functioning autism spectrum disorders and anxiety: a randomized trial. Child Psychol Psychiatry. 2012 53(4):410-9. https://doi.org/10.1111/j.1469-7610.2011.02486.x
  8. Reaven J, Hepburn S. Cognitive-behavioural treatment of obsessive-compulsive disorder in a child with Asperger syndrome: a case report. Autism 2003; 7(2):145–164. https://doi.org/10.1177/1362361303007002003
  9. Sofronoff K, Attwood T, Hinton S, et al. A randomized controlled trial of a cognitive behavioural intervention for anger management in children diagnosed with Asperger syndrome. J Autism Dev Disord 2007; 37(7):1203–1214 https://doi.org/10.1007/s10803-006-0262-3
  10. Bauminger, N. The facilitation of social-emotional understanding and social interaction in high- functioning children with Autism: Intervention outcomes. Journal of Autism and Developmental Disorders 2002; 32(4), 283-298. https://doi.org/10.1023/a:1016378718278
  11. Sze, K., & Wood, J. Cognitive behavioural treatment of comorbid anxiety disorders and social difficulties in children with high-functioning autism: A case report. Journal of Contemporary Psychotherapy 2007; 37, 133–143 https://doi.org/10.1007/s10879-007-9048-y
  12. Hare, D. & Flood, A. Approaching work with people with a diagnosis of Asperger’s syndrome: Some notes for the perplexed. Clinical Psychology Forum 2001;147, 11-17. https://doi.org/10.53841/bpscpf.2001.1.147.11
  13. Abeles, P, Verduyn, C, Robinson, et al. Computerized CBT for adolescent depression (“Stressbusters”) and its initial evaluation through an extended case series. Behavioural and Cognitive Psychotherapy 2009 37 (2) 151-65 https://doi.org/10.1017/s1352465808005067
  14. Holtmann M, Steiner S, Hohmann S, Poustka L, et al. Neurofeedback in autism spectrum disorders. Dev Med Child Neurol 2011; 53(11): 986-93 https://doi.org/10.1111/j.1469-8749.2011.04043.x
  15. Anderson S., Morris J. Cognitive behaviour therapy for people with Asperger syndrome. Behavioural and Cognitive Psychotherapy 2006; 34(3): 293-303 https://doi.org/10.1017/s1352465805002651
  16. Baron-Cohen, S. Mind Reading: The Interactive Guide to Emotions. DVD-ROM set. University of Cambridge; 2002               
  17. Gray, C. The New Social StoryTM Book. Arlington, TX: Future Horizons; 2010   
  18. Gray, C. Social stories and comic strip conversations with students with Asperger syndrome and high-functioning autism. In E. Schopler (Ed.), Asperger Syndrome or High Functioning Autism? (pp. 167–194). New York: Plenum Press; 2010 https://doi.org/10.1007/978-1-4615-5369-4_9
  19. Hulbert, R. T., Happé, F. and Frith, U. Sampling the form of inner experience in three adults with Asperger’s syndrome. Psychological Medicine 1994; 24, 385-95 https://doi.org/10.1017/s0033291700027367
  20. Attwood, T. Framework for behavioural interventions. Child and Adolescent Psychiatric Clinics of North America 2004; 12, 65-86 https://doi.org/10.1016/s1056-4993(02)00054-8
  21. Gaus, V. “I feel like an alien”: Individual psychotherapy for adults with Asperger’s disorder using a cognitive behavioural approach. NADD Bulletin 2000; 3, 62–65